An Uncommon Ammunition Case: Interpreting “Transitional” Textiles and Social Worlds in Nineteenth-Century Tlingit Alaska

Overlooked objects in museum collections can reveal complex social relationships behind well-known textile forms. A tattered woven case for ammunition cartridges, collected in southern Alaska in the late nineteenth century, presents such an opportunity. Part of the vast Tlingit collection at the American Museum of Natural History, the ammunition bag has been little documented and displayed compared to other highly esteemed indigenous naaxein or Chilkat weavings of the region. The piece is unusual in that the maker combined two weaving styles—not only figural motifs characteristic of Chilkat weaving, but also geometric patterns reminiscent of its stylistic and technical precursor called Raven’s Tail, of which few historic pieces remain. In this paper, I analyze the bag’s design, manufacture, and use, and contextualize its attributes using comparative objects, ethnohistorical sources, and contemporary dialogues with weavers and others from the Northwest Coast. I suggest that this case’s specific patterns, construction, and symbolism attest to major transitions (as well as continuities) occurring within Tlingit communities during the nineteenth century, a period of intense colonial pressure. These transitions include gender shifts in textile design, an increase in militaristic symbolism in ceremonial potlatch regalia, and adaptations in the look and socioeconomic roles of dress, textiles, and basketry. I interpret this special case as a connective object, linking shifting modes of expression and social relations during a time of transformation for indigenous groups of the Northwest Coast

A Cost-Effectiveness Study of Home-Based Stroke Rehabilitation

Stroke is often a severe and debilitating event that requires ongoing rehabilitation. The Community Stroke Rehabilitation Teams (CSRT) offer home-based stroke rehabilitation to individuals for whom further therapy is unavailable or inaccessible. The objective of this study was to evaluate the cost-effectiveness of the CSRT program compared with a ‘No Therapy’ cohort. Data was collected on CSRT clients from January 2012 to February 2013. Comparator data were derived from a study of stroke survivors with limited access to rehabilitation. Literature derived values were used to inform a long-term projection. Using Markov modelling, we projected the model for 35 years. One-way, two-way, and Probabilistic Sensitivity Analyses were performed. Results demonstrate that the CSRT has a Net Monetary Benefit of $43,115 over No Therapy, and is both less costly and more effective. The CSRT model of care should be considered when evaluating potential stroke rehabilitation delivery methods

Soybean rust

"Asian soybean rust is a serious foliage disease that has the potential to cause significant soybean yield losses. Although Asian soybean rust was identified on soybean plants in Hawaii in 1994, the disease was not reported in the continental United States until the fall of 2004. The U.S. Department of Agriculture (USDA) released an official notice of the confirmation of soybean rust on soybean leaf samples collected in Louisiana on November 10, 2004. Over the next few weeks the fungus was detected on plants from a number of additional states, including Missouri. Now that Asian soybean rust has been found in the continental United States, it is critical that anyone involved in soybean production be familiar with the disease and its identification and management."--Page 1.Laura E. Sweets (Department of Plant Microbiology and Pathology and Commercial Agriculture Program), J. Allen Wrather (Department of Plant Microbiology and Pathology, Delta Research Center), Simeon Wright (Plant Diagnostic Clinic)New 12/04/15MIncludes bibliographical reference

Caregivers’ Perception of the IPad’s Utility for Augmentative and Alternative Communication (AAC): A Conflict between Illusion and Reality

The primary purpose of this study was to compare perceptions of the iPad’s utility for augmentative and alternative communication (AAC) in individuals with autism spectrum disorder (ASD). A sample of 15 caregivers, eight of whom cared for individuals who had iPads (“users”) and seven of whom cared for individuals who did not have iPads (“non-users”), responded to a survey created by the authors to identify possible helpfulness of the iPad’s for enhancing communication. Non-users’ perceptions of the potential utility of the iPad were statistically significantly greater than those of the caregivers who had utilized the iPad for AAC. These findings strongly suggest a conflict between the non-users’ illusions and the users’ subjective reality regarding the iPad’s potential to improve communication skills

Visual stress and dyslexia for the practicing optometrist

Visual stress should not be confused with dyslexia. It refers to symptoms of discomfort and perceptual distortion that have a neurological origin. Pattern 2 of the Pattern Glare Test can be used to elicit symptoms of visual stress, but pattern 3 is of relatively little clinical use. The symptoms sometimes remit with tints, but studies consistently show that tinting precision well within 0.07 in the CIE 1976 UCS diagram is necessary for optimal effect (see Precision is necessary – strong evidence is now available, below).  An improvement in reading speed with filters (overlays or lenses) can be measured using the Wilkins Rate of Reading Test, and an increase in reading speed of 15% is likely to indicate an improvement that exceeds any due to random variation. Visual stress remains a controversial issue, partly because of the publicity surrounding untrialled methods and partly because of reviews that are partial

Implementing GRACE Team Care in a Veterans Affairs Medical Center: Lessons Learned and Impacts Observed

In a randomized clinical trial, Geriatric Resources for Assessment and Care of Elders (GRACE), a model of care that works in collaboration with primary care providers (PCPs) and patient-centered medical homes to provide home-based geriatric care management focusing on geriatric syndromes and psychosocial problems commonly found in older adults, improved care quality and reduced acute care use for high-risk, low-income older adults. To assess the effect of GRACE at a Veterans Affairs (VA) Medical Center (VAMC), veterans aged 65 and older from Marion County, Indiana, with PCPs from four of five VAMC clinics who were not on hospice or dialysis were enrolled in GRACE after discharge home from an acute hospitalization. After an initial home-based transition visit to GRACE enrollees, the GRACE team returned to conduct a geriatric assessment. Guided by 12 protocols and input from an interdisciplinary panel and the PCP, the GRACE team developed and implemented a veteran-centric care plan. Hospitalized veterans from the fifth clinic, who otherwise met enrollment criteria, served as a usual-care comparison group. Demographic, comorbidity, and usage data were drawn from VA databases. The GRACE and comparison groups were similar in age, sex, and burden of comorbidity, although predicted risk of 1-year mortality in GRACE veterans was higher. Even so, GRACE enrollment was associated with 7.1% fewer emergency department visits, 14.8% fewer 30-day readmissions, 37.9% fewer hospital admissions, and 28.5% fewer total bed days of care, saving the VAMC an estimated $200,000 per year after program costs during the study for the 179 veterans enrolled in GRACE. Having engaged, enthusiastic VA leadership and GRACE staff; aligning closely with the medical home; and accommodating patient acuity were among the important lessons learned during implementation